Drug interactions
Benzhydrocodone / acetaminophen + Imipramine
Severity: Major
Benzhydrocodone / acetaminophen and Imipramine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Opioids combined with sedating tricyclics increase CNS and respiratory depression. Imipramine may also raise serotonergic risk and hydrocodone is metabolized partly by CYP2D6, which is inhibited by tricyclics.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Imipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS depression, with possible serotonergic and CYP2D6-related effects.
What to do
Reserve combined use for patients without alternatives, using the lowest doses for the shortest time. Monitor for sedation, respiratory depression and serotonin toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Imipramine
- Dronedarone + Imipramine Contraindicated
- Imipramine + Isocarboxazid Contraindicated
- Imipramine + Phenelzine Contraindicated
- Imipramine + Pimozide Contraindicated
- Imipramine + Rasagiline Contraindicated
- Imipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Imipramine?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Imipramine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Opioids combined with sedating tricyclics increase CNS and respiratory depression. Imipramine may also raise serotonergic risk and hydrocodone is metabolized partly by CYP2D6, which is inhibited by tricyclics.
How serious is the interaction between Benzhydrocodone / acetaminophen and Imipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve combined use for patients without alternatives, using the lowest doses for the shortest time. Monitor for sedation, respiratory depression and serotonin toxicity.
What other medicines interact with Imipramine?
MediHelp also lists interactions of Imipramine with, for example, Dronedarone, Isocarboxazid, Phenelzine. The full list is on the Imipramine page.
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